Influences for change in the dental health status of populations: an historical perspective

Epidemiologists often use mortality statistics to examine trends in health and disease,*9 principally because these data are frequently all that are available, and also because they are reasonably reliable.@ A major drawback to their use, however, is that mortality statistics are an extremely crude measure of health status, for they say nothing about the quality or degree of illness and disability in a population. The dental epidemiologist’s equivalent of mortality statistics is data on the loss of teeth. Until recently, these data, too, were frequently the only existing dental statistics. Tooth mortality data are a crude measure of dental health, but they also can probably be compared over time with reasonable confidence. This paper attempts to find reasons for any changes in dental health status over the last 50-100 years. Scarcity of data requires that tooth retention be used as a measure of dental health, despite its inadequacy; it also restricts the assessment of dental disease prevalence in an historical perspective almost totally to dental canes. Another constraint is that most historical data are available only from the United States and Great Britain; it is contended, however, that the conclusions reached from these countries can be more widely applied.